Mpox Clade I in the U.S. Should Be a Wake-Up Call
— Sustained global health investment is the need of the hour
With mpox clade I cases confirmed in California (Nov 2024) and Georgia (Jan 2025), the risk is real and growing. In our MedpageToday article co-authored by Jason Kindrachuk, PhD, Anne W. Rimoin, PhD, MPH and myself, we lay out a roadmap for the Trump administration to lead on global health security—but the recent announcement of a U.S. withdrawal from WHO undermines this effort. Without urgent investment in global health infrastructure, Clade I mpox risks becoming endemic—just like Clade II. Time to act, not retreat!
Here’s a Quick Summary
The recent detections of Clade I mpox in the U.S. serves as a stark reminder of global health interconnectedness and the urgent need for sustained investment in pandemic preparedness. Clade I, historically more severe than Clade II, has already caused over 57,000 suspected cases and 1,200 deaths in 2024, with travel-associated cases now appearing in Europe, Asia, and North America.
We emphasizes that without decisive action, Clade I mpox could follow Clade II’s trajectory—spreading globally and exacerbating existing health inequities.
Key Recommendations for U.S. Leadership:
Invest in Global Health Infrastructure – Expand vaccine access, strengthen healthcare systems, and address misinformation in endemic regions like the Democratic Republic of the Congo (DRC), where children account for 75% of cases.
Prevent Clade I from Becoming Endemic – Learn from Clade II’s spread by bolstering surveillance, research, and public health response in affected regions.
Enhance Diagnostic and Surveillance Systems – Improve early detection through expanded laboratory capacity and field epidemiology programs.
Strengthen Domestic Preparedness – Train healthcare providers, maintain stockpiles of vaccines and treatments, and develop novel therapeutics beyond tecovirimat (Tpoxx), which showed limited efficacy for Clade II mpox.
Support Innovative Global Solutions – Ensure continued engagement with the WHO, fund clinical trials for alternative vaccines, and expand biosecurity measures to reduce zoonotic transmission.
The Stakes and Opportunity
We argue that the Trump administration has a critical opportunity to lead on global health security. By acting now, the U.S. can contain Clade I mpox, protect vulnerable populations, and demonstrate that pandemic preparedness is a strategic necessity, not just a moral obligation. The key lesson from COVID-19 and Clade II mpox is clear: early investment in prevention saves lives and reduces long-term costs. However, the U.S. withdrawal from the WHO poses significant challenges to the global response to mpox, undermining efforts to control current outbreaks and prevent future ones.
Read our full op ed here: https://www.medpagetoday.com/opinion/second-opinions/113735